Medio-lateral motion of the center of mass during obstacle crossing distinguishes elderly individuals with imbalance

This study was performed to investigate whether elderly patients with imbalance can be distinguished from healthy elderly subjects by comparing their whole body center of mass (COM) motion in the medio-lateral (M-L) direction during obstacle crossing. Nine healthy elderly adults and six elderly patients having complaints of 'dizziness' or 'unsteadiness' during walking (three with bilateral/unilateral vestibular weakness and three with unclear diagnosis) were recruited to perform unobstructed level walking and crossing of obstacles set to 2.5, 5, 10 and 15% of each subject's height. Kinematics of the COM was calculated using a weighted sum average of a 13-segment biomechanical model. There were no significant group differences for the temporal-distance gait parameters during all testing conditions. However, elderly patients with balance disorders demonstrated significantly greater and faster lateral motion of the COM when crossing over obstacles. These measurements distinguish elderly patients with imbalance from healthy elderly subjects. Furthermore, the increased M-L motion of the COM during obstacle crossing showed a positive correlation with an increased M-L range of motion of the swing foot trajectory. This increase in M-L motion indicates a compensatory adjustment in the swing foot trajectory to land the swing foot at an appropriate location that would establish a new base of support to counter the balance disturbance in the frontal plane.